Drug interactions
Pegaspargase + Tolmetin
Severity: Moderate
Pegaspargase and Tolmetin: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Pegaspargase can lower coagulation factors and fibrinogen and may cause thrombocytopenia, which raises bleeding risk. Tolmetin adds platelet inhibition and gastrointestinal mucosal injury, so bleeding events may be more likely.
What this interaction means in plain words
Pegaspargase and Tolmetin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Pegaspargase belongs to Oncology; Tolmetin belongs to Musculoskeletal.
Why it happens
Pharmacodynamic synergism: asparaginase-related coagulopathy combined with NSAID-induced platelet dysfunction.
What to do
Avoid NSAIDs during periods of asparaginase-induced coagulopathy or thrombocytopenia where possible, and use paracetamol for analgesia. Monitor platelet count, fibrinogen and coagulation tests.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Pegaspargase and Tolmetin, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Tolmetin
- Ketorolac intranasal + Tolmetin Contraindicated
- Ketorolac + Tolmetin Contraindicated
- Aceclofenac + Tolmetin Major
- Acemetacin + Tolmetin Major
- Alteplase + Tolmetin Major
- Amlodipine-hydrochlorothiazide-valsartan + Tolmetin Major
Other interactions of Pegaspargase
- Etodolac + Pegaspargase Major
- Ketorolac + Pegaspargase Major
- Mefenamic acid + Pegaspargase Major
- Acetylsalicylic acid + Pegaspargase Moderate
- Argatroban + Pegaspargase Moderate
- Celecoxib + Pegaspargase Moderate
Frequently asked questions
Can I take Pegaspargase with Tolmetin?
MediHelp rates the interaction as moderate. Pegaspargase and Tolmetin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Pegaspargase can lower coagulation factors and fibrinogen and may cause thrombocytopenia, which raises bleeding risk. Tolmetin adds platelet inhibition and gastrointestinal mucosal injury, so bleeding events may be more likely.
How serious is the interaction between Pegaspargase and Tolmetin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid NSAIDs during periods of asparaginase-induced coagulopathy or thrombocytopenia where possible, and use paracetamol for analgesia. Monitor platelet count, fibrinogen and coagulation tests.
What other medicines interact with Tolmetin?
MediHelp also lists interactions of Tolmetin with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Tolmetin page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
